Gary M McCray MD SC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

036064789 Issued in IL

Legal business name

GARY M MCCRAY MD SC

Practice address

1530 Alima Ter
La Grange Park, IL 60526-1331

Phone

(708) 783-5572

Fax

(708) 482-4093

NPI assigned

Feb 10, 2009

Last updated

Feb 13, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

GARY M MCCRAY MD SCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary Myles McCray, MDNPI 1023025541

Title

Owner

Phone

(708) 783-5572

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Gary M McCray MD SC

  • Geriatric Medicine (Internal Medicine) Physician
  • La Grange Park, IL
  • NPI 1255512976

  O20050509000126

  Same enrollment

Tax ID family

Gary M McCray MD SC2 organizations share this tax ID, including this one

Part of

Gary M McCray MD SC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gary M McCray MD SC

  • Geriatric Medicine (Internal Medicine) Physician
  • La Grange Park, IL
  • NPI 1255512976
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Gary M McCray MD SC

  • Geriatric Medicine (Internal Medicine) Physician
  • La Grange Park, IL
  • NPI 1255512976
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary Myles McCray, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • La Grange Park, IL
  • NPI 1023025541
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1407095805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 ALIMA TER",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261331",
            "telephone_number": "708-783-5572",
            "fax_number": "708-482-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 ALIMA TER",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261331",
            "telephone_number": "708-783-5572",
            "fax_number": "708-482-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY M MCCRAY MD SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GARY M MCCRAY MD SC",
        "enumeration_date": "2009-02-10",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "MCCRAY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "MYLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-783-5572",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036064789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064789",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD",
            "identifier": "01621773",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE I NPI",
            "identifier": "1023025541",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II NPI",
            "identifier": "1255512976",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logan Foreit
• James Patrick Franko, LPC
• Kristen Joy Frayn, OTR/L
• Sarah Gadomski
• Gary M McCray MD SC
• Jordan Alexander Gillard
• Michael J. Glavin, M. D.
• Cynthia Elena Gonzalez
• Cara Gray
• Grove of Lagrange Park LLC

• Geriatric Medicine (Internal Medicine) Physician in La Grange Park, IL
• Providers in La Grange Park, IL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.